The Journal of Thoracic and Cardiovascular Surgery
Volume 138, Issue 6 , Pages 1269-1275.e1 , December 2009

Unifocalization of major aortopulmonary collateral arteries in pulmonary atresia with ventricular septal defect is essential to achieve excellent outcomes irrespective of native pulmonary artery morphology

  • Ben Davies, MRCS(Eng), PhD

      Affiliations

    • Department of Cardiac Surgery, Birmingham Children's Hospital, Birmingham, United Kingdom
    • Corresponding Author InformationAddress for reprints: Ben Davies, MRCS(Eng), PhD, Department of Cardiac Surgery, Birmingham Children's Hospital, Steelhouse Lane, Birmingham B4 6NH, United Kingdom.
  • ,
  • Shafi Mussa, MA, MD, MRCS(Eng)

      Affiliations

    • Department of Cardiac Surgery, Birmingham Children's Hospital, Birmingham, United Kingdom
  • ,
  • Paul Davies, PhD

      Affiliations

    • Institute of Child Health, Birmingham Children's Hospital, Birmingham, United Kingdom
  • ,
  • John Stickley, BSc

      Affiliations

    • Department of Cardiac Services, Birmingham Children's Hospital, Birmingham, United Kingdom
  • ,
  • Timothy J. Jones, MD, FRCS(CTh)

      Affiliations

    • Department of Cardiac Surgery, Birmingham Children's Hospital, Birmingham, United Kingdom
  • ,
  • David J. Barron, MD, MRCP, FRCS(CTh)

      Affiliations

    • Department of Cardiac Surgery, Birmingham Children's Hospital, Birmingham, United Kingdom
  • ,
  • William J. Brawn, FRCS, FRACS

      Affiliations

    • Department of Cardiac Surgery, Birmingham Children's Hospital, Birmingham, United Kingdom

Received 26 April 2009 ,Revised 2 July 2009 ,Accepted 9 August 2009.

References 

  1. Bull K, Somerville J, Ty E, Spiegelhalter D. Presentation and attrition in complex pulmonary atresia. J Am Coll Cardiol. 1995;25:491
  2. Leonard H, Derrick G, O'Sullivan J, Wren C. Natural and unnatural history of pulmonary atresia. Heart. 2000;84:499–503
  3. Kirklin JW, Blackstone EH, Shimazaki Y, Maehara T, Pacifico AD, Kirklin JK, et al. Survival, functional status, and reoperations after repair of tetralogy of Fallot with pulmonary atresia. J Thorac Cardiovasc Surg. 1988;96:102–116
  4. Puga FJ, Leoni FE, Julsrud PR, Mair DD. Complete repair of pulmonary atresia, ventricular septal defect, and severe peripheral arborization abnormalities of the central pulmonary arteries. Experience with preliminary unifocalization procedures in 38 patients. J Thorac Cardiovasc Surg. 1989;98:1018–1029
  5. Marelli AJ, Perloff JK, Child JS, Laks H. Pulmonary atresia with ventricular septal defect in adults. Circulation. 1994;89:243–251
  6. Haworth SG, Macartney FJ. Growth and development of pulmonary circulation in pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries. Br Heart J. 1980;44:14–24
  7. Liao PK, Edwards WD, Julsrud PR, Puga FJ, Danielson GK, Feldt RH. Pulmonary blood supply in patients with pulmonary atresia and ventricular septal defect. J Am Coll Cardiol. 1985;6:1343–1350
  8. Amin Z, McElhinney DB, Reddy VM, Moore P, Hanley FL, Teitel DF. Coronary to pulmonary artery collaterals in patients with pulmonary atresia and ventricular septal defect. Ann Thorac Surg. 2000;70:119–123
  9. Reddy VM, McElhinney DB, Amin Z, Moore P, Parry AJ, Teitel DF, et al. Early and intermediate outcomes after repair of pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries: experience with 85 patients. Circulation. 2000;101:1826–1832
  10. d'Udekem Y, Alphonso N, Norgaard MA, Cochrane AD, Grigg LE, Wilkinson JL, et al. Pulmonary atresia with ventricular septal defects and major aortopulmonary collateral arteries: unifocalization brings no long-term benefits. J Thorac Cardiovasc Surg. 2005;130:1496
  11. Griselli M, McGuirk SP, Winlaw DS, Stumper O, de Giovanni JV, Miller P, et al. The influence of pulmonary artery morphology on the results of operations for major aortopulmonary collateral arteries and complex congenital heart defects. J Thorac Cardiovasc Surg. 2004;127:251–258
  12. Brawn WJ, Jones T, Davies B, Barron D. How we manage patients with major aorta pulmonary collaterals. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2009;152–157
  13. Tchervenkov CI, Salasidis G, Cecere R, Beland MJ, Jutras L, Paquet M, et al. One-stage midline unifocalization and complete repair in infancy versus multiple-stage unifocalization followed by repair for complex heart disease with major aortopulmonary collaterals. J Thorac Cardiovasc Surg. 1997;114:727–737
  14. Carotti A, Albanese SB, Minniti G, Guccione P, Di Donato RM. Increasing experience with integrated approach to pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries. Eur J Cardiothorac Surg. 2003;23:719–727
  15. Lofland GK. The management of pulmonary atresia, ventricular septal defect, and multiple aorta pulmonary collateral arteries by definitive single stage repair in early infancy. Eur J Cardiothorac Surg. 2000;18:480–486
  16. Metras D, Chetaille P, Kreitmann B, Fraisse A, Ghez O, Riberi A. Pulmonary atresia with ventricular septal defect, extremely hypoplastic pulmonary arteries, major aorto-pulmonary collaterals. Eur J Cardiothorac Surg. 2001;20:590–597
  17. Cho JM, Puga FJ, Danielson GK, Dearani JA, Mair DD, Hagler DJ, et al. Early and long-term results of the surgical treatment of tetralogy of Fallot with pulmonary atresia, with or without major aortopulmonary collateral arteries. J Thorac Cardiovasc Surg. 2002;124:70–81
  18. Amark KM, Karamlou T, O'Carroll A, MacDonald C, Freedom RM, Yoo SJ, et al. Independent factors associated with mortality, reintervention, and achievement of complete repair in children with pulmonary atresia with ventricular septal defect. J Am Coll Cardiol. 2006;47:1448–1456
  19. Tchervenkov CI, Roy N. Congenital Heart Surgery Nomenclature and Database Project: pulmonary atresia—ventricular septal defect. Ann Thorac Surg. 2000;69(4 Suppl):S97–S105
  20. Piehler JM, Danielson GK, McGoon DC, Wallace RB, Fulton RE, Mair DD. Management of pulmonary atresia with ventricular septal defect and hypoplastic pulmonary arteries by right ventricular outflow construction. J Thorac Cardiovasc Surg. 1980;80:552–567
  21. Norgaard MA, Alphonso N, Cochrane AD, Menahem S, Brizard CP. d'Udekem Y. Major aorto-pulmonary collateral arteries of patients with pulmonary atresia and ventricular septal defect are dilated bronchial arteries. Eur J Cardiothorac Surg. 2006;29:653–658
  22. DeRuiter MC, Gittenberger-de Groot AC, Poelmann RE, VanIperen L, Mentink MM. Development of the pharyngeal arch system related to the pulmonary and bronchial vessels in the avian embryo. With a concept on systemic-pulmonary collateral artery formation. Circulation. 1993;87:1306–1319

PII: S0022-5223(09)01045-9

doi: 10.1016/j.jtcvs.2009.08.011

The Journal of Thoracic and Cardiovascular Surgery
Volume 138, Issue 6 , Pages 1269-1275.e1 , December 2009